Yes

Caloric Agent

Source of calories and essential fatty acids for patients requiring parenteral nutrition of extended duration

B/C

Pathologic hyperlipidemia, lipoid nephrosis, known hypersensitivity to fat emulsion and severe egg or legume (soybean) allergies, pancreatitis with hyperlipemia

Use caution in patients with severe liver damage, pulmonary disease, anemia, or blood coagulation disorder; use with caution in jaundiced, premature, and low birth weight children

>10%: Local: Thrombophlebitis

1% to 10%: Endocrine & metabolic: Hyperlipemia

<1%: Cyanosis, flushing, chest pain, nausea, vomiting, diarrhea, hepatomegaly, dyspnea, sepsis

Too rapid administration results in fluid or fat overloading to cause dilution of serum electrolytes, overhydration, pulmonary edema, impaired pulmonary diffusion capacity, metabolic acidosis

Treatment is supportive

May be stored at room temperature; do not store partly used bottles for later use; do not use if emulsion appears to be oiling out

Essential for normal structure and function of cell membranes

Metabolism: Undergoes lipolysis to free fatty acids, which are utilized by reticuloendothelial cells

Half-life: 0.5-1 hour

Fat emulsion should not exceed 60% of the total daily calories

Infants and Children: Initial dose: 0.5-1 g/kg/day, increase by 0.5 g/kg/day to a maximum of 3 g/kg/day depending on needs/nutritional goals; maximum rate of infusion: 0.25 g/kg/hour (1.25 mL/kg/hour of 20% solution)

Adolescents and Adults: Initial dose: 1 g/kg/day, increase by 0.5-1 g/kg/day to a maximum of 2.5 g/kg/day of 10% and 3 g/kg/day of 20% depending on needs/nutritional goals; maximum rate of infusion: 0.25 g/kg/hour (1.25 mL/kg/hour of 20% solution); do not exceed 50 mL/hour (20%) or 100 mL/hour (10%)

Prevention of essential fatty acid deficiency (8% to 10% of total caloric intake): 0.5-1 g/kg/24 hours

Children: 5-10 mL/kg/day at 0.1 mL/minute then up to 100 mL/hour

Adults: 500 mL (10%) twice weekly at rate of 1 mL/minute for 30 minutes, then increase to 42 mL/hour (500 mL over 12 hours)

Note: At the onset of therapy, the patient should be observed for any immediate allergic reactions such as dyspnea, cyanosis, and fever; slower initial rates of infusion may be used for the first 10-15 minutes of the infusion (eg, 0.1 mL/minute of 10% or 0.05 mL/minute of 20% solution)

Serum triglycerides; before initiation of therapy and at least weekly during therapy

No information available to require special precautions

No effects or complications reported

Report pain at infusion site, difficulty breathing, chest pain, calf pain, or excessive sweating.

May be simultaneously infused with amino acid dextrose mixtures by means of Y-connector located near infusion site

Injection: 10% [100 mg/mL] (100 mL, 250 mL, 500 mL); 20% [200 mg/mL] (100 mL, 250 mL, 500 mL)

Haumont D, Richelle M, Deckelbaum RJ, et al, "Effect of Liposomal Content of Lipid Emulsions of Plasma Lipid Concentrations in Low Birth Weight Infants Receiving Parenteral Nutrition," J Pediatr, 1992, 121(5 Pt 1):759-63.

Neuzil J, Darlow BA, Inder TE, et al, "Oxidation of Parenteral Lipid Emulsion by Ambient and Phototherapy Lights: Potential Toxicity of Routine Parenteral Feeding," J Pediatr, 1995, 126(5 Pt 1):785-90.